Stress cardiomyopathy differential diagnosis: Difference between revisions

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Line 32: Line 32:
|[[Chest pain]], [[dyspnea]]
|[[Chest pain]], [[dyspnea]]
|↑↑↑
|↑↑↑
|N/A
| -
|[[ST elevation]] in [[precordial leads]]
|[[ST elevation]] in [[precordial leads]]
|Dysfunction at area of [[infarction]]
|Dysfunction at area of [[infarction]]
Line 39: Line 39:
|[[Chest pain]], [[dyspnea]], [[fever]]
|[[Chest pain]], [[dyspnea]], [[fever]]
|May be acutely elevated
|May be acutely elevated
|N/A
| -
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]]
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]]
|Diffuse [[hypokinesia]]
|Diffuse [[hypokinesia]]
Line 46: Line 46:
|[[Dyspnea]], [[dyspnea on exertion]], [[cough]], [[edema]], [[fatigue]]
|[[Dyspnea]], [[dyspnea on exertion]], [[cough]], [[edema]], [[fatigue]]
|Usually negative
|Usually negative
|N/A
| -
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]]
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]]
|[[LV]] enlargement
|[[LV]] enlargement
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|[[Chest pain]], [[dyspnea]], [[syncope]], [[sudden cardiac death]]
|[[Chest pain]], [[dyspnea]], [[syncope]], [[sudden cardiac death]]
|Usually negative
|Usually negative
|N/A
| -
|Common findings include:
|Common findings include:
* [[Right axis deviation|Right]] or [[left axis deviation]]
* [[Right axis deviation|Right]] or [[left axis deviation]]

Revision as of 22:17, 23 October 2017

Stress cardiomyopathy Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Stress Cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

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Cost-Effectiveness of Therapy

Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of anterior MI and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to pheochromocytoma.

Differentiating Stress Cardiomyopathy from other Diseases

The presentation of stress cardiomyopathy mimics that of anterior wall MI and must be differentiated from it. However, other medical conditions that must also be differentiated from stress cardiomyopathy include:[1][2]

Disease Can Present With Cardiac Enzymes Catecholamine Levels ECG Findings Echocardiography Findings
Stress Cardiomyopathy Chest pain, dyspnea Transiently elevated ST elevation in precordial leads LV regional dysfunction
Pheochromocytoma Chest pain, dyspnea Can be positive Persistently elevated ST elevation in precordial leads LV regional dysfunction
Anterior MI Chest pain, dyspnea ↑↑↑ - ST elevation in precordial leads Dysfunction at area of infarction
Myocarditis Chest pain, dyspnea, fever May be acutely elevated - May show atrial fibrillation, LBBB or AV block Diffuse hypokinesia
Dilated Cardiomyopathy Dyspnea, dyspnea on exertion, cough, edema, fatigue Usually negative - May show atrial fibrillation, LBBB or AV block LV enlargement
Hypertrophic Cardiomyopathy Chest pain, dyspnea, syncope, sudden cardiac death Usually negative - Common findings include: LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy

References

  1. Parodi G, Del Pace S, Carrabba N, Salvadori C, Memisha G, Simonetti I, Antoniucci D, Gensini GF (2007). "Incidence, clinical findings, and outcome of women with left ventricular apical ballooning syndrome". Am. J. Cardiol. 99 (2): 182–5. doi:10.1016/j.amjcard.2006.07.080. PMID 17223415.
  2. Mikail N, Hess S, Jesel L, El Ghannudi S, El Husseini Z, Trinh A, Ohlmann P, Morel O, Imperiale A (2013). "Takotsubo and Takotsubo-like syndrome: a common neurogenic myocardial stunning pathway?". Int. J. Cardiol. 166 (1): 248–50. doi:10.1016/j.ijcard.2012.09.116. PMID 23058349.

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